Supplementation - Is it good? Bad? How long for, if ever?

It’s common thought that someone who takes ‘nutritional supplements’, are probably gym junkies, downing their protein powers, bars, and goodness knows what else. This is far from the truth, supplement use goes beyond the gym doors, and can be used by anyone for any reason. In the case of eating disorders, fortified flavoured drinks (commonly names Fortisips, Ensure, Boost, and Resource) are regularly used and are orally consumed, carrying around 300 calories per bottle. If the patient is tube fed, via a naso-gastric (NG) tube, similar solutions (often Osmolite) are used and the calories per millilitre can vary.

The use of such drinks is common among malnourished patients, elderly, eating disorder sufferers, individuals with digestive or intestinal issues – but can be used by anyone who cannot reach their dietary requirements from food alone. NG feeding is used across a much larger variety of reasons – including those in comas or suffered significant injury impacting on their physical ability to swallow or consume food as well as the before mentioned examples.

I relied upon drinking 2-3 Fortisips each day for eighteen months in order to ensure my body got enough energy in to make steady and the necessary gains required for me during this time. For you shake-virgins out there, think of these drinks as like an Up & Go, but with more of a boost and much sweeter and thicker (the consistency almost like a drinkable yogurt). You get pretty good at finding ways of getting them into your body without your eating disorder feeling funky about it. I baked with it, added it to my morning cereal, made hot drinks, used it as a base for smoothies, froze it – I was on them long enough that I was able to get creative with them and the flavours they came in (definitely on team caramel and vanilla over here – note to readers, avoid the juice versions or tropical flavours, that shit’s nasty). These were added into my diet when I had already restored some of my weight, but I needed an extra boost in energy to keep making decent gains and at the time could not add any more to my diet comfortably. This may be read as the easy way out, and perhaps a way of avoiding the foods I was afraid of; but at the time, the main goal was to get energy into my body in any form and sort out the types of foods I am consuming when I was in a more stable place with my weight and mentality toward food. At the end of this time period, I began to phase drinks out and add more food in to compensate for this. I never had any more contact of voluntary drinking Fortisips or other forms of such drinks, until my second inpatient admission onto an eating disorder ward.

When inpatient, if you are not able to complete the entire meal or snack on offer within a set period of time, you were to be supplemented with a nutritional drink, and if you refused that then things got tricky and serious consideration of NG feeding begins. Toward the final stages of my second admission, I was maxed out on the meal plans offered, having added every extra possible (and then some!), but my weight was not where it needed to be. I had an NG tube for almost three weeks, and it is something I would not wish upon my worst enemy. Keep in mind that I was not underweight at this point – you do not have to be underweight to have an NG tube. The actual placement of the tube is extremely uncomfortable and distressing (especially if you are not willing to have one place), after all – its not a natural thing to have a tube stuck up your nose, down your throat and into your stomach! I spent 1 ½ weeks being supplemented with an additional 1,000 calories each day on top of my maxed meal plan – which got my weight gain back on track. The momentum soon slowed, so the energy of my feed was increased to 1,500 calories per day, and this saw me finally crack the range where my team wanted me to be sitting within. I was hooked up to my bottle of feed each night, and the feed went through the tube while I was sleeping, around 8-10 hours all up each day. I didn’t necessarily like it (but who really does, or who would?), but I can appreciate how necessary and vital it was for me to have the tube at that time.

So, if you are considering adding supplementary nutrition into your diet, here is my advice. Know that it is not a way of getting out of eating – sooner or later you will need to replace the energy from those drinks with real foods, it is very easy to become a little too comfortable with these drinks. Secondly, you do not need to be underweight to have supplement drinks, and you do not need to be ashamed if you consume them in front of people – like I said before, there are many reasons for taking these drinks. The same message goes for subtracting these drinks – they need to be replaced with food that has sufficient energy in it, so you need to be prepared to eat more (or at least take in the same amount of energy).

If you do not want to take the shakes from your health professional, or perhaps you aren’t under any specialist care, there are still ways you can have these drinks. They are available in your local pharmacy, but are usually unsubsidised. You can also buy packs of Up & Go’s or similar breakfast drinks and use these instead. Alternatively, you can make your own shakes with protein powder, milk, ice-cream, yogurt, berries and other fruits, milk, nut and nut butters – the list is endless! Get creative and you’ll be surprised with how tasty some concoctions can be.

Rawing Meg xx